Point Prevalence Survey of Antimicrobial Use in Small Acute Care Hospitals in Nova Scotia
Author(s): ,
Heather Neville
Affiliations:
BScPharm MSc
,
Mia Losier
Affiliations:
BSc(Pharm) student
,
Megan Harrison
Affiliations:
BScPharm
,
Kim Abbass
Affiliations:
BScPharm PharmD
,
Kathy Slayter
Affiliations:
BScPharm PharmD FCSHP
,
Lynn Johnston
Affiliations:
MD MSc FRCPC
Ingrid Sketris
Affiliations:
BScPharm PharmD MPA(HSA)
Canadian Pharmacists Conference ePoster Library. Black E. Jun 3, 2017; 174250
Dr. Emily Black
Dr. Emily Black
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Abstract
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Objectives
Point prevalence surveys (PPS) are used to monitor antimicrobial use and identify targets for improvement through antimicrobial stewardship (AMS) activities. The objective of this study was to determine prevalence and characterize antimicrobial use at acute care hospitals in small communities across Nova Scotia (NS).

Methods
Hospitals in rural or small to medium population centers (population < 100 000) with at least 30 acute care beds were invited to participate in a PPS of antimicrobial use in 2015. Paper-based inpatient charts were reviewed to identify adult and pediatric patients receiving a systemic antimicrobial agent by 0800 on the day of the survey. Data was gathered on type of antimicrobial agent prescribed, dose, administration route, intended duration of use, and indication. Adherence to regional guidelines for 4 indications was also assessed in adult patients. Results were summarized descriptively.

Results
Ten of the 11 hospitals in small communities meeting inclusion criteria participated. Most hospitals had clinical pharmacists however, only 1 hospital had an on-site AMS pharmacist and few hospitals had an infectious disease specialist. The overall prevalence of antimicrobial use among the 10 hospitals was 27.6% (233/845) and ranged from 20.3% (13/64) to 43.5% (30/69). The most common indications for antimicrobial use were respiratory tract infections (19.8%), urinary tract infections (16.5%), and prophylaxis (16.5%). The most frequently prescribed class of antimicrobial agents were cephalosporin antibiotics (28.0%) and quinolones (20.0%). The majority of patients (61.1%) received parenteral antimicrobial agents. Low uptake of regional guidelines was identified.

Conclusion
Antimicrobial agents were frequently prescribed to acute care patients in small community hospitals. A number of AMS targets were identified. Clinical pharmacists working in communities without comprehensive AMS programs or resources can play an important role in improving antimicrobial use through initiatives such as promotion of intravenous to oral de-escalation and encouraging adherence to regional guidelines.

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